Objective To explore the effects of sevoflurane and propofol combined with medetomidine in peritoneoscope gallbladder resection and postoperative cognitive function and oxidative stress response.
Methods Altogether 74 cases of laparoscopic cholecystectomy were divided into two groups. All patients were given preoperative intramuscular injection of dexmedetomidine with midazolam and fentanyl for anesthesia induction. The observation group was given inhalation of sevoflurane with target controlled infusion of dexmedetomidine for maintenance of anesthesia. The control group was given propofol target controlled infusion combined with dexmedetomidine for maintenance of anesthesia. Postoperative recovery was compared between the two groups. Changes of postoperative cognitive function in patients were assessed with minimental state examination (MMSE) score. Changes of S100 beta protein and oxidative stress in patients were detected before and after surgery.
Results There was no significant difference in the operation time between the two groups (
P >0. 05). The observation group awake time and extubation time, recovery time were significantly lower than those in the control group. The difference was statistically significant (
t=5. 870, 10. 226, 8. 527,
P < 0. 05). At 6 hours, 12 hours and 24 hours after operation, the MMSE score of the observation group was significantly higher than that of the control group.The difference was statistically significant (
t=3. 417, 3. 800, 3. 048,
P < 0. 05). 24 h after operation, the observation group S100 beta protein was significantly lower than the control group. The difference was statistically significant (
t=4. 768,
P <0. 05). SOD and MDA were significantly improved after operation in two groups, and T-AOC was significantly decreased (
P < 0. 05). For the observation group MDA and SOD were significantly lower than those in the control group. T-AOC was significantly higher than the control group. The difference was statistically significant (
t=4. 689, 4. 073, 8. 518,
P <0. 05).
Conclusion Compared with propofol, sevoflurane composite dexmedetomidine can significantly reduce oxidative stress reaction for patients after a laparoscopic cholecystectomy, thus to protect cognitive functions.
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